Objectives:

• Describe the appropriate evaluation of polyarthritis
• Diagnose Lyme disease
• Describe the stages of Lyme disease
• Implement appropriate therapy for Lyme disease
• Discuss preventive strategies for Lyme disease and describe some of the complications of the disease

1		Your young patient’s mother presents with diffuse aching and stiffness worsened by cold weather and stress. She recalls being treated for Lyme disease herself 2 years ago. The physical examination is remarkable for tender points bilaterally at the occiput, trapezius, lateral epicondyle, gluteus, and knee. There is no redness, swelling, or synovial thickening at the knees and elbows. You suspect that her symptoms are due to which of the following?
			A)	Chronic Lyme disease.
			B)	Osteoarthritis.
			C)	Fibromyalgia.
			D)	Rheumatoid arthritis.
2		Which of the following is (are) NOT associated with Lyme disease?
			A)	Cranial nerve palsies.
			B)	Unilateral facial paralysis.
			C)	“Aseptic” meningitis.
			D)	Mononeuritis multiplex.
			E)	All of the above are associated with Lyme disease.